ABSTRACT
Objective To study three-dimensional reconstruction system (IQQA-Liver) in evaluation of resection volume and margin of hepatocellular carcinoma.Method Data of 51 hepatocellular carcinoma patients undergoing hepatectomy from March 2014 to October 2015 were analyzed retrospectively.All patients received preoperative ultrasound and CT/MIR evaluation.Three-dimensional reconstruction system (IQQA-Liver) was used to reconstruct tumor shape and location,the relationship between tumor and adjacent vessels or bile ducts.Then liver volume,liver resection volume,residual liver volume and surgical margin were calculated and compared with the actual resection liver values and actual margin.Results Images of three-dimensional reconstruction system (IQQA-Liver) were accurate,clear and directly perceived.In terms of the resection liver volume and resection margin,there was no significant difference between the predicted results and actual results [resection liver volume:(412.93 ± 471.26)cm3 vs.(487.02±529.01)cm3,t=0.75,P=0.46,resection margin:(13.72 ± 4.58) mm vs.(13.92 ±4.21)mm,t =0.23,P =0.82].The predicted resection liver volume was significantly correlated with the actual resection volume (r =0.91,P ＜ 0.01),the predicted resection margin was also correlated with the actual resection margin (r =0.89,P ＜ 0.01).Conclusion Three-dimensional reconstruction system (IQQALivcr) could accurately assess the resection volumc and margin of hepatocellular carcinoma.
ABSTRACT
Objective To compare the clinical effect of total laparoscopic and open liver resection for tumors in segments Ⅶ and Ⅷ.Methods The clinical data of patients with tumors in segments Ⅶ and Ⅷ of the liver who met the inclusion criteria and received operation at Affiliated Hospital of Nantong University from January 2011 to January 2015 were retrospectively analyzed.Among these patients, there were 17 cases who received total laparoscopic liver resection (LLR group), and 25 cases who received open liver resection (OLR group).Results LLR group has obvious advantages in aspects of the level of serum alanine transaminase (ALT) on 1st and 3rd day postoperation, the time anal exsufflation, the drainage volume of abdominal cavity in 3 days after operation and the postoperative hospital stay than those in OLR group (respectively t =-3.075,-3.175,-2.499,-2.088,-2.419, all P ＜ 0.05).There were no significant differences in blood transfusion rate, the resection margin to the tumor, the postoperative morbidity and the total medical cost between the two groups (x2 =1.437, t =-1.244, x2 =0.209, t =1.079, all P ＞ 0.05).Though the mean operative time and intraoperative blood loss of LLR group compared with OLR group increased obviously (respectively t =3.360, 2.189, all P ＜ 0.05).During the postoperative follow-up, there were no significant differences in the postoperative recurrence rate and the long-term survival rate in patients with malignant tumors (respectively x2 =0.240, 0.000, all P ＞ 0.05).Conclusion The therapeutic effect of total laparoscopic and open liver resection are equal in segments Ⅷ and Ⅷ hepatectomy, while, LLR has advantages of less trauma.